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A 70-year old  man with severe comorbidities, hemodynamically stable, was emergently admitted for bowel obstruction. His chronic intractable constipation had never been  evaluated.  The patient had  no history of abdominal  surgery.  Computed tomography indicated a large obstructive rectosigmoid tumour  and dolichocolon.   Immediate rectoscopy confirmed the presence of the obstructive tumour. Additionally, on emergent laparotomy, a malformed  right-sided  duodenum with right-sided small bowel and other midgut malrotation defects, along with a small palpable lesion in the proximal descending colon, were also found. We performed a subtotal  colectomy, mobilization of the only existing first and second duodenal portions,  division of mesenteric root adhesions, and  a terminal ileostomy. The patient had a favourable outcome, was discharged on day 8. Histology revealed a pT3N1b rectosigmoid adenocarcinoma and an 1 cm in diameter localized  c-kit+ stromal tumour in the proximal descending colon.  He received chemotherapy. The patient underwent a postoperative upper gastrointestinal contrast study which showed a well-functioning right-sided deranged duodenum. During a 36-months follow-up no recurrence of malignancy or of midgut malrotation defects has been recognized.


congenital duodenal malformation duodenal dysgenesis duodenal displacement superior mesenteric vessels' rotation midgut malrotation

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How to Cite
Avgoustou, C., & Avgoustou, C. (2021). Obscure duodenal malformation and other midgut malrotation defects in an elder with acute abdomen due to different prominent complicated pathology. Journal of Gastric Surgery, 3(2).


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